Accounts Receivable Agent Liaison (Remote 8am-5pm EST)

by twochickswithasidehustle | Nov 8, 2024 | Uncategorized

Overview

The Opportunity

Accounts Receivable Agent Liaison – Remote Opportunity (Must be located in FL, GA, SC, AL, TX, NJ, AZ, MI, NV, or PA)

Pay starting at $19.25 per hour

We are seeking to add an Accounts Receivable Agent Liaison to our team. This role is a remote opportunity but applicants should note that they must live in one of the follow states: FL, GA, SC, AL, X, or PA. Our accounts receivable team plays an important role of working closely with insurance agents to ensure policy premiums are collected and applied to the correct policy. As an A/R Agent Liaison, job duties include analyzing an agent’s account and calling for past due amounts. They will also request notices of cancellation and post checks as necessary. The ideal candidate for this role will have great customer service skills, the ability to multi-task, and be detail oriented.

Benefits of Joining Our Team:

• Paid Time Off
• 10 Paid Holidays
• 401(k) with company match up
• Medical, Dental, & Vision insurance
• Supplemental benefits including company paid long-term disability and life insurance.

Responsibilities

Responsibilities include:

• Contact agents for payment prior to initiating direct notice of cancellation of policy.
• Send earned premium letters.
• Research checks posted incorrectly.
• Handle incoming calls, emails and faxes from agents.
• Work closely with the supervisor regarding past due items.
• Handle finance company calls.
• Handle Company Payables calls/emails – contact agents on policies which demand immediate payment.
• Prepare payments to the Agent/Finance Companies.
• Request Notices of Cancellation for unpaid policies.
• Post agent and finance company checks, wires, and ACHs
• Rescind paid policies
• Email Statements and Late Notices to agents
• Prepare Daily Cash Report
• Review Producer Payable Report

Qualifications

Job Requirements:

• High School Diploma or General Education Diploma (G.E.D.)
• 1 year of Accounts Receivable or Customer Service experience preferred
• Strong customer orientation, excellent interpersonal and communication skills
• Strong problem analysis and resolution skills
• Must be able to prioritize and be responsive to complex issues
• Detail oriented and able to multi-task
• Proficient in Microsoft Word, Excel and Outlook – knowledge of accounting desired

Team Lead

by twochickswithasidehustle | Nov 5, 2024 | Uncategorized

Overview

Job Title:  Help Desk Team Lead

Salary:  $20-$27 per hour

Employee Type:  Full-Time Hourly Non-Exempt

About Cayuse Commercial Services, LLC:

In addition to talent and resources, contracting with Cayuse provides a relationship that values inclusion and racial equity. A minority business that is 100% Native American owned, we engage in purposeful partnerships with impactful missions. 

• Our Brand reflects the amazing people who bring the solutions to life.
• Our Mission is to grow the company, grow the people.
• Our Ultimate Vision is to advance our heritage through innovation.

Cayuse operates in 18 countries with four offices. Our headquarters are located on the CTUIR reservation in Pendleton, Oregon. It is here that we house our 40,000 square foot facility and Network Security Operations Center. We have additional satellite offices in Honolulu, Hawaii, and Rosslyn, Virginia.

Primary Focus

The Team Lead is responsible for leading the daily operations of the Help Desk/Service Desk project for Cayuse. Includes responsibility for meeting customer service and other project-specific service levels and goals. This position performs all duties and responsibilities in accordance with the Mission, Vision, and Core Values of Cayuse.

Responsibilities

Job Responsibilities

• Handles escalations from client customers and management.
• Monitors Quality Assurance: reviews data and uses it to educate, coach, meet and improve on expected quality goals.
• Monitors, generates, and delivers performance analysis for the project.
• Assists in ensuring that workload standards are being met according to the expectations and guidelines established for the project staff.
• Facilitates and ensures staff have the technical and customer service training necessary for successful execution of their duties to meet project standards.
• Responsible for interaction with client and contractor contacts to resolve issues.
• Oversees the tools used by project and agents; includes implementation and process documentation.
• Has oversight of Call Queue, Email/Inbox, and Chat monitoring and performance.
• Creates and communicates staff work schedules and associated duties: time and attendance compliance, monitoring and submitting Cayuse and project time sheets, shift coverage and changes.
• Supervises the Agents/Senior Agents working in front-end operations and assists, and coaches Leads in driving agent compliance on processes and procedures.
• Works collaboratively to ensure Project guidelines are understood, communicated, and monitored for compliance by agents, leads and other employees associated with the Project.
• Coordinates client triage and escalations.
• Collaborates with the Knowledge Management/Training Lead, QA Lead, and Reporting Lead on customer service improvement, metrics, call/chat/ticket handling processes, and improvement.
• Responsible for the agents and senior agents that are handling customer contacts.
• Leverages Performance Analysis and integrates into Senior Agents coaching and development and staff compliance.
• Gathers data, writes, and delivers performance evaluation for assigned employees in accordance with Cayuse and Project guidelines.
• Proactive approach to work; must be reliable and flexible.
• Assists senior leadership with continuous improvement through ongoing collection of data and information regarding customer requirements.
• Ability to troubleshoot, analyze, and resolve project issues using available tools and resources.
• Other duties as assigned.

Qualifications

Minimum Job Skills and Qualifications

Minimum Qualifications:

• High school diploma or GED required.
• 1-3 years of supervisor experience, preferred.
• Must be able to pass a background check. May require additional background checks as required by projects and/or clients at any time during employment.

Minimum Skills:

• Understanding of all tools used to run the Project successfully: technical, service and reporting.
• Understanding of project reporting and metrics
• Ability to multitask and demonstrate time management skills.
• Ability to change system settings via control panels or system preferences.
• Sufficient skills to allow understanding of all Training materials, in both written and oral formats.
• Ability to coach, train, develop, monitor, and perform all other aspects of supervision.
• Professional oral, written and presentation communication skills.
• Analytical and self-directed; ability to work independently and as part of a team.
• Ability to convey ideas and concepts effectively to others.
• Positive attitude: tolerance to deal effectively with difficult and stressful situations.
• Exhibits leadership qualities and leads by example.
• Strong customer focus
• Proficient with Microsoft Office Suite or related software.

Reports to: Delivery Manager

Working Conditions

•   Professional remote office environment.

• Must be physically and mentally able to perform duties extended periods of time.
• Ability to use a computer and other office productivity tools with sufficient speed to meet the demands of this position.
• Must be able to establish a productive and professional workspace.
• Must be able to sit for long periods of time looking at computer screen.
• May be asked to work a flexible schedule which may include holidays.
• May be asked to travel for business or professional development purposes.
• May be asked to work hours outside of normal business hours.

Other Duties: Please note this job description is not designed to cover or contain a comprehensive list of activities, duties or responsibilities that are required of the employee for this job.  Duties, responsibilities, and activities may change at any time with or without notice.

Affirmative Action/EEO Statement: Cayuse embraces diversity and equal opportunity in a serious way. We celebrate diversity and are committed to creating and building a team that represents a variety of backgrounds, perspectives, and skills. Cayuse, and all of its subsidiaries, are proud to be an equal opportunity workplace and are an affirmative action employer.

Pay Range

USD $20.00 – USD $27.00 /Hr.

Payment Operations Specialist

by twochickswithasidehustle | Nov 5, 2024 | Uncategorized

Our Mission and Opportunity

Early education is one of the greatest determinants of childhood outcomes, is a must for working families, and has a lasting social and economic impact. Brightwheel’s vision is to enable high quality early education for every child — by giving teachers meaningfully more time with students each day, engaging parents in the development of their kids, and supporting the small businesses that make up the backbone of the $175 billion early education market. Brightwheel is the most loved technology brand in early education globally, trusted by thousands of educators and millions of families.

Our Team

We are a fully remote team with employees across every time zone in the US. Our team is passionate, talented, and customer-focused. Our exceptional investor group includes Addition, Bessemer Venture Partners, Chan Zuckerberg Initiative, GGV Capital, Lowercase Capital, Emerson Collective, and Mark Cuban. 

We believe that everyone—from our employees to the students, teachers, and administrators we serve— should be given the opportunity to learn and thrive, whatever their background may be. We celebrate diversity in all forms because it allows our team and the communities we serve to reach their full potential and do their best work. From decision making, to how we operate, we ground ourselves in our Leadership Principles every day. 

Who You Are

brightwheel is seeking an experienced Payment Operations Specialist to join our dynamic Payment Operations team. As our payments business expands rapidly, this team is crucial in safeguarding brightwheel and our customers from fraud while resolving challenging payment issues.

You thrive in high-impact roles and are passionate about fraud detection and risk mitigation. In a fast-paced environment, you excel at process-oriented tasks and have a keen eye for detail. You are energized by reviewing a high volume of new account signups and strive for continuous improvement. You desire to get better every day and possess an unwavering drive to achieve excellence and deliver extraordinary results.

What You’ll Do

• Conduct KYC Checks: Perform a high volume of Know Your Customer (KYC) checks for customers onboarding to our billing platform (~60-80% of your time, depending on the season).
• Resolve Payment Disputes: Manage and resolve payment disputes (chargebacks), screen high-risk and suspicious payments, and investigate complex payment issues (~20% of your time).
• Investigate Activity: Identify and resolve complex payment issues and suspicious activities on the billing platform.
• Customer Interaction: Engage directly with customers via phone and email to provide world-class service and quick resolutions.
• Collaborate Across Teams: Support other functions at brightwheel as needed to enhance our operations.

Qualifications, Skills, & Abilities

• 3+ years experience in a customer-facing role
• 1+ year of experience in fraud prevention, detection, and investigation
• 1+ year of experience in processing and mitigating disputes (chargebacks)
• Strong written and verbal communication skills
• Extreme attention to detail in all aspects of your work
• Proven analytical and problem-solving skills, with the ability to create structure in ambiguous situations, investigate root causes, and propose effective solutions.

$23.08 – $28.85 an hour

For cash compensation, brightwheel sets standard ranges for all roles based on function, level, and geographic location, benchmarked against similar-stage growth companies. Multiple factors determine final offer amounts, including geographic location, candidate experience, and expertise. If you have questions about the compensation band for your region, please ask your recruiter.

LOB Risk Specialist – Basel Capital

by twochickswithasidehustle | Nov 5, 2024 | Uncategorized

Position Overview

At PNC, our people are our greatest differentiator and competitive advantage in the markets we serve. We are all united in delivering the best experience for our customers. We work together each day to foster an inclusive workplace culture where all of our employees feel respected, valued and have an opportunity to contribute to the company’s success. As a LOB Risk Specialist – Basel Capital, you will be you will be within PNC’s Risk, Change, Experience & Strategy (RCES) organization, supporting the Capital Management Team. This is a remote position. Work may be performed from a quiet, confidential space in a home location, approved by PNC. This position may not be available in all geographic locations.

This position will be responsible for the performance of Basel regulatory capital requirements. Primary responsibilities will include data analysis, quarterly reporting, certification support, control performance, data quality, and program documentation. Successful candidates will be expected to utilize data techniques to perform analysis to ensure appropriate categorization, evaluate results, and articulate impacts. This role partners primarily with finance, lines of business, and data governance. Preferred qualifications of the position include but are not limited to the following:

• Ability to extract, manipulate, and present data analysis (strong Excel skills at minimum)
• Foundational knowledge of internal C&IB source systems capturing credit data elements and financial reporting tools
• Understanding of bank financial statements, banking products, credit risk, and financial analysis

Job Description

• Assists in the execution of the Line of Business Risk Management program, identifying opportunities for enhancement where applicable. Under supervision, enables line of business adherence with risk programs.
• Assists in the design and development of the risk management program to meet business and regulatory expectations.
• Executes the risk management program within or across the lines of business (e.g. – business self-assessment and quality reviews). Participates in the consultation to execute the program components.
• Works to develop risk expertise while working with the businesses and other risk partners (e.g., Compliance, Credit, Legal, Audit).
• Participates in risk initiatives, business as usual activities, ad hoc requests, and identifies risk exposures.

PNC Employees take pride in our reputation and to continue building upon that we expect our employees to be:

• Customer Focused – Knowledgeable of the values and practices that align customer needs and satisfaction as primary considerations in all business decisions and able to leverage that information in creating customized customer solutions.
• Managing Risk – Assessing and effectively managing all of the risks associated with their business objectives and activities to ensure they adhere to and support PNC’s Enterprise Risk Management Framework.

Qualifications

Successful candidates must demonstrate appropriate knowledge, skills, and abilities for a role. Listed below are skills, competencies, work experience, education, and required certifications/licensures needed to be successful in this position.

Preferred Skills

Change Management, Conflict Management, Crisis Management, Emerging Risks, Influencing Change, Operations Management, Risk Management Programs, Strategic Planning

Competencies

Accuracy and Attention to Detail, Collaborating, Data Gathering and Reporting, Decision Making and Critical Thinking, Effective Communications, Industry Knowledge, Internal Controls, Operational Risk, Operations – Back Office, Process Management, Standard Operating Procedures

Work Experience

Roles at this level typically require a university / college degree, with 2+ years of relevant professional experience. In lieu of a degree, a comparable combination of education, job specific certification(s), and experience (including military service) may be considered.

Education

Bachelors

Certifications

No Required Certification(s)

Licenses

No Required License(s)

Benefits

PNC offers a comprehensive range of benefits to help meet your needs now and in the future. Depending on your eligibility, options for full-time employees include: medical/prescription drug coverage (with a Health Savings Account feature), dental and vision options; employee and spouse/child life insurance; short and long-term disability protection; 401(k) with PNC match, pension and stock purchase plans; dependent care reimbursement account; back-up child/elder care; adoption, surrogacy, and doula reimbursement; educational assistance, including select programs fully paid; a robust wellness program with financial incentives.In addition, PNC generally provides the following paid time off, depending on your eligibility*: maternity and/or parental leave; up to 11 paid holidays each year; 8 occasional absence days each year, unless otherwise required by law; between 15 to 25 vacation days each year, depending on career level; and years of service.

To learn more about these and other programs, including benefits for full time and part-time employees, visit pncbenefits.com > New to PNC.

Health Care Investigator

by twochickswithasidehustle | Nov 5, 2024 | Uncategorized

Overview

Now hiring a Health Care Investigator.

• Remote: Open to remote applicants in the United States, except for the following states: Wyoming, North Dakota, and Ohio

The SIU Investigator III supports Program Integrity Department initiatives at Presbyterian Health Plan. The Special Investigative Unit (SIU) Investigator III is responsible for conducting medium to highly complex reviews into suspected or actual healthcare fraud, waste, or abuse with respect to provider, pharmacy, employee, member, and broker interactions involving the full range of products at Presbyterian. This includes the identification, investigation, prevention, and reporting of fraudulent, wasteful, and/or abusive billing and/or coding practices and/or patterns; requesting and reviewing medical record documentation to determine if services billed were rendered and/or appropriate based on documentation; interviewing suspect(s) and/or witness(es) with knowledge of the suspect and/or actual fraud, waste, or abuse; coordination of recovery of overpayments related to fraudulent, abusive, and/or wasteful billing and/or coding practices; and providing education related to coding/representation of services and appropriate medical record documentation requirements. The ideal candidate should have proficient experience in healthcare claims fraud, waste and abuse investigation, with experience in government funded programs like Medicaid, Medicare, and the Marketplace, along with Commercial health plans, to include Federal Employee Health Benefits Plan, and Self-Funded accounts.

How you belong matters here.

We value our employees’ differences and find strength in the diversity of our team and community.

At Presbyterian, it’s not just what we do that matters. It’s how we do it – and it starts with our incredible team. From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members.

Why Join Us

• Full Time – Exempt: Yes
• Job is based Rev Hugh Cooper Admin Center
• Work hours: Days
• Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.

Qualifications

• Bachelors degree, plus three years related healthcare experience required. Six years of additional experience can be substituted in lieu of degree.
• Certified Professional Coder (CPC) through the American Academy of Professional Coders (AAPC) or equivalent required
• Preferred Qualifications
• Certified Professional Medical Auditor (CPMA) through the AAPC
• Certified Fraud Examiner (CFE) or Accredited Health Care Fraud Investigator (AHFI)

Responsibilities

• Medium to high complexity reviews/investigations involving provider, pharmacy, employee, member, and broker issues
• Must be able to perform in-depth and complex medical coding audits in both an accurate and timely manner as part of the Special Investigative Units proactive effort, as well as referral-based issues, that are brought to the attention of the unit
• Strong and accurate technical and report writing skills are required, as case management documentation, reports and/or referrals to government agencies, and legally binding documents are produced and handled by the SIU
• Maintain accurate, current, and detailed case information in the SIU case management system
• Strong verbal communication skills are required due to interface with government agencies, providers, and internal departmental collaboration
• Strong analytical skills necessary as this position will require interface with health plan claims system, the vendor fraud analytics system, the SIU case management system, and other systems utilized by the SIU in investigating fraud, waste, and abuse allegations
• Ability to work independently to achieve Program Integrity Department and SIU objectives.
• Critical thinking and attention to detail
• Resolving conflict that arises from provider audit results and/or issues resulting from a fraud, waste, or abuse investigation
• Conduct research into coding rules and/or guidelines, or other state or federal rules and/or laws depending on the nature of the suspect fraud, waste, or abuse
• Maintains caseload and manages daily case review assignments and productivity standards with attention and accountability towards achieving a quality product
• Monitor cases post-audit to determine if continued aberrancies exist that require additional follow-up and review
  Intermediate level of:
• Ensures adherence to state and federal laws and regulations, managed care awareness, along with reimbursement and coding policies and guidelines, to include internal Presbyterian Health Plan enterprise operations, functions, and processes
  Intermediate level using:
• MS Office (Word, Excel, PowerPoint)
• Adobe Pro
• Internet
• Microsoft Teams and/or Zoom
• In collaboration with SIU Manager and Senior Investigator, manages the overall direction, coordination, implementation, execution, and completion of assigned investigations ensuring consistency with department strategy, commitments, and goals
• Responsible for concurrent and/or retrospective review, data abstraction, analysis, identification of critical issues, process improvement support, required education, and assisting with measurement of performance metrics
• Serves as resource recommending process modifications and practice changes to improve efficiency, effectiveness, and reliability of processes and systems
• Builds and develops collaborative relationships vital to the success of cases and department
• Conducts advanced fraud, waste and abuse audits in accordance with compliance and audit work-plan and prepares detailed audit reports for management, legal counsel, and providers
• Identifies, investigates, and resolves billing and coding related inquiries and complaints from beneficiaries, members, regulatory agencies and internal and external customers through recoupment of overpayments and education to providers

Benefits

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness
Presbyterian’s Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.